Risk Factors for Depression - Research Paper Example

? Depression: Evidences of Risk Factors, Signs and Symptoms, and Treatment Methods al Affiliation Depression is a common andpotentially dangerous condition, especially when not given immediate attention. It could affect any individual regardless of age, education, et cetera, depending on the risk factors that he or she possesses for depression. Certain risk factors like low socio-economic status, work-related psychosocial stressors, genetic predispositions, gender, negative life experiences, and other physical disabilities, show to increase the incidence of depression. Consequences of the condition, including suicide, imply that there is a need to know its signs and symptoms, as well as treatment methods that are available. The best treatment options are said to be the combination of both medications and psychotherapy, but electroconvulsive therapy (ECT) is also an option when others do not work. Depression: Evidences of Risk Factors, Signs and Symptoms, and Treatment Methods Introduction The human experience of sadness and gloom is normal among individuals, but it may be different once it becomes chronic and interferes with activities of daily living. Depression is one of the common causes in seeking professional psychologic help, and timely interventions could greatly help the depressed individual. Although depression may appear to be merely preoccupations of negative emotions, it can lead to dreadful effects, including suicide, once neglected. The diagnosis of depression may also be co-existing with other illnesses as well. It comes in different types with several signs and symptoms, and may be caused by a variety of elements, of which the present text will explore the risk factors associated with the condition using recent studies as evidences. Risk factors Numerous researches have been published to study risk factors of depression. In a 7-year longitudinal population study, Lorant et al. (2007) determined if longitudinal change in socio-economic factors affect change of depression level. Low socio-economic status, especially in the context of material standards of living, has constantly been associated with increased incidence of depression. Results gathered show that a decline in socio-economic status is consequent to increased risks of depression, looking also into ceasing cohabitation with a partner and unemployment. Ceasing cohabitation with a partner increased risk levels of depression particularly among women; and unemployment did not influence the level or risk of depression, in contrast to other cited studies, but with considerations of the research design and methods (p. 296). It is also seen that generally, the negative effects of worsening socio-economic conditions were greater than the positive effects when these conditions improved (p. 296). This study presents that socio-economic factors, including income, poverty, unemployment, education, and social relationships, are linked to prevalence of depression, where both have an inversely proportional relationship. Netterstrom et al. (2008) focus on work-related psychosocial stressors in relation to the development of depression. Using several models, the authors review previous researches to assess such relationship, basing on either psychiatric scales, scales with with diagnostic classifications, or antidepressant prescription, or depression measured with a questionnaire (p. 121). According to the review, occupational psychosocial factors were associated with the development of depression, especially in instances where there are high psychological demands and low degree of social support (p. 126). Demands would, however, vary according to the job and the work setting. This review, in accordance to the studies looked into, implies that an individual’s work, especially job satisfaction and social support in such occupation, is linked to depression. When an individual feels satisfied and fulfilled with his or her job and receives positive reinforcement, there are lesser chances for depression, and vice versa. Depression is also seen to have genetic risk factors, of which Kendler et al. (2009) delineate two genetic pathways to major depression: (1) high familial loading for major depression (MD), which they predicted would be most prominent in cases of MD with an early age at onset (AAO); and (2) high familial loading for vascular disease (VD), which should be the strongest in MD cases with late AAO (p. 808). Specific genes that affect the risk of MD are not yet known, but are currently being ventured. Outcomes of the study of a sample of Swedish twins exposed that familial or genetic factors that showed risk for MD tend to manifest in early onset forms, as well as a “significant positive relationship between AAO in depressed twins and the risk for objectively determined VD in their cotwin” (p. 810). Further, onset of MD in adolescence and early adulthood increased the risk of familial loading for MD. Thus, not only are environmental factors accountable for increased risks of depression, but genetic make-up also have a role to play for acquiring the condition. Although it is published in many papers that women are at higher risk for depression as compared to men, Hyde et al. (2008) contend that an integrated, developmental model to support such is lacking, thus prompting them to propose one that integrates affective, biological, and cognitive models to explain the emergence of gender difference in depression (p. 291). Authors conclude that affect includes temperament, wherein negative emotionality is a vulnerability to depression; biological components include genetic influences, and pubertal hormones and timing; cognitive components are negative cognitive style, rumination, and objectified body consciousness; and social factors such as negative life events heighten these vulnerabilities (p. 305). The specific components in the integrated model are common among adolescent girls, thus increasing their risks for depression as they go into adulthood. In addition, Seeley, Stice, and Rohde (2009) identified adolescent girls at high risk for future depression and indicated that “the most potent predictors of major depression onset included subthreshold depressive symptoms, poor school and family functioning, low parental support, bulimic symptoms, and delinquency” (p. 161). Through the knowledge given by these studies, there can be improved efforts on preventing the onset of depression among adolescent girls, and consequently, women. Depression in other physical conditions Risk factors previously mentioned are those which may be found or occur in otherwise well-functioning individuals. Besides these, however, there are also risk factors for depression in special populations, especially among those who have had physical debilitations, and are currently experiencing other physical conditions. Epilepsy is usually regarded as a serious neurologic condition, perceived by some, including those who experience it, as a dreadful and hopeless case. Because of this, Grzyb et al. (2006) study about the risk factors for depression in patients with epilepsy. Previous researches have presented that depressive symptoms occur in 40-60% of patients with epilepsy, and outcomes of the cited work have shown that 49.2% suffered from concurrent depression, 37.4% had severe depression, and 11.8% had mild depression (p. 411). It was further exposed that the type of seizures, frequency of attacks, certain pharmacologic treatment, and lack of occupational and social activity contribute to the emergence of depressive symptoms in these clients. Separately, risk factors of depression and anxiety specifically in children and adolescence with epilepsy were ventured, revealing that depression in adolescents may be more complicated than those in adults, and are “likely multifactorial, involving neurobiological, psychosocial, and iatrogenic risk factors” (Ekinci et al., 2009, p. 9). Although several researches have established increased incidence of depression among those with vascular problems, there is also a contention that individuals with a history of multiple strokes, hypertension, smoking, peripheral vascular disease, and visible discrete subcortical lesion or basal ganglia changes on baseline computed tomography (CT) scans had autonomous connection with major post-stroke depression at the chronic phase (Chatterjee et al., 2010, p. 9). In addition, increased age and presence of frontal subdural bleeding are significant findings in a depressed individual who experienced a mild traumatic brain injury (Rao et al., 2010). Signs and symptoms Since depression may lead to severe unwanted consequences, it is important to be aware of its signs and symptoms. Generally, established manifestations of a person diagnosed, or most probable to be diagnosed, with depression are weight changes - either loss or gain; loss of interest or alterations in performing daily activities; insomnia or hypersomnia; feelings of hopelessness; physical, mental, emotional exhaustion; problems in focusing; and even presence of suicidal ideations, the most dangerous sign. Treatment methods Treatment options for depression are referred to differently, depending on the specific cases of the clients, basing on signs and symptoms, diagnosis, and factors that predispose and precipitate depression; and the response of individuals to regimens vary as well. According to Olfson et al. (2006), it is more likely that individuals continue antidepressant therapy beyond 30 days if they received psychotherapy, completed 12 or more years of education, or had private health insurance (p. 101). This study implies that socio-economic factors play a role in the response to treatment, and that the co-existence of both pharmacologic and psychologic or psychiatric managements is more advantageous rather than having only either of them. In a systematic review of researches on the effectiveness of psychological treatment of depression in primary care, Cuijpers et al. (2009) find that such regimen is effective in primary care patients (p. e58). However, it is better known that consulting a specialist may yield better results. It has also been established that the combination of medications and psychotherapy and counselling are so far the best options. Treatment medications for depressive symptoms include atypical antidepressants, selective serotonin reuptake inhibotors (SSRIs), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs). Furthermore, talking about the causes of depression through psychotherapy, of which cognitive behavioral is the most common, is recognized to alleviate symptoms. When medications and psychotherapy do not present expected outcomes, individuals may be suggested for electoconvulsive therapy (ECT) to affect neurotransmitters in the brain. References Chatterjee, K., Fall, S., & Barer, D. (2010). Mood after stroke: A case control study of biochemical, neuro-imaging and socio-economic risk factors for major depression in stroke survivors. BioMedCentral Neurology, 10, 1-10. Retrieved from http://www.biomedcentral.com/content/pdf/1471-2377-10-125.pdf Cuijpers, P., van Straten, A., van Schaik, A., & Andersson, G. (2009). Psychological treatment of depression in primary care: A meta-analysis. British Journal of General Practice, e51-e60. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629842/pdf/bjgp59-e51.pdf Ekinci, O., Titus, J. B., Rodopman, A. A., Berkem, M., & Trevathan, E. (2009). Depression and anxiety in children and adolescents with epilepsy: Prevalence, risk factors, and treatment. Epilepsy & Behavior, 14, 8-18. Grzyb, A. G., Jedrzejczak, J., Naganska, E., & Fiszer, U. (2006). Risk factors for depression in patients with epilepsy. Epilepsy & Behavior, 8, 411-417. Hyde, J. S., Mezulis, A. H., & Abramson, L. Y. (2008). The ABCs of depression: Integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychological Review, 115(2), 291-313. Kendler, K. S., Fiske, A., Gardner, C. O., & Gatz, M. (2009). Delineation of two genetic pathways to major depression. Biological Psychiatry, 65(9), 808-811. Lorant, V., Croux, C., Weich, S., Deliege, D., Mackenbach, J., & Ansseau, M. (2007). Depression and socio-economic risk factors: 7-year longitudinal population study. The British Journal of Psychiatry, 190, 293-298. Olfson, M., Marcus, S. C., Tedeschi, M., & Wan, G. J. (2006). Continuity of antidepressant treatment for adults with depression in the United States. American Journal of Psychiatry, 163, 101-108. Netterstrom, B., Conrad, N., Bech, P., Fink, P., Olsen, O., Rugulies, R., & Stansfeld, S. (2008). The relation between work-related psychosocial factors and the development of depression. Epidemiologic Reviews, 30, 118-132. Rao, V., Bertrand, M., Rosenberg, P., Makley, M., Schretlen, D. J., Brandt, J., & Mielke, M. M. (2010). Predictors of new-onset depression after mild traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 22, 100-104. Seeley, J. R., Stice, E., & Rohde, P. (2009). Screening for depression prevention: Identifying adolescent girls at high risk for future depression. Journal of Abnormal Psychology, 118(1), 161-170. Read More